Droperidol, propofol and alizapride, in a decreasing order of effectiveness in the doses used in this study, reduced the incidence of pruritus induced by the use of morphine 0.2 mg intrathecally. On the other hand, promethazine 50 mg was shown to be ineffective.
The nitrones of α-phenyl-tert-butyl nitrone (PBN) and 4-hydroxyl-PBN (4-OH-PBN) that have anticancer activity in models of liver cancer and glioblastomas, were tested in the ApcMin/+ mouse model. Mice were administered PBN and 4-OH-PBN in drinking water and intestinal tumor size and number assessed after 3-4 months. Throughout the experiment, contrast-enhanced magnetic resonance imaging (MRI) was used to monitor colon tumors. MRI data showed a time-dependent significant increase in total colonic signal intensity in sham-treated mice, but a significant decrease for PBN-treated mice, and slight decrease for 4-OHPBN treated mice probably due to the limited water solubility of 4-OH-PBN. Final pathological and percent survival data agreed with the MRI data. PBN had little effect on oxaliplatin-mediated killing of HCT116 colon cancer cells and caused only a slight decrease in the amount of active fraction caspase 3 in oxaliplatin-treated cells. PBN has significant anti-cancer activity in this model of intestinal neoplasia.
DESCRIPTIONA 72-years-old woman presented with intermittent chest pains, anterolateral T-wave inversions on ECG and troponin-T of 6290 ng/L. Acute coronary syndrome treatment was initiated. The coronary angiography demonstrated tortuous calcified coronaries without any significant obstructive lesion. However, late dye acquisition images revealed a capillary blush originating from the diagonal branch of left anterior descending artery (figures 1 and 2) and the distal right coronary artery (figures 3 and 4) feeding into the ventricular cavity through intramural thebesian vein connections, almost producing a ventriculogram (figures 5 and 6).This episode which otherwise would been an undetectable plaque event, turned out to be one of significant myocardial injury due to background presence of the 'the coronary steal' syndrome.Persistence of embryonic coronary artery fistulas in form of diffuse vascular network directly draining oxygenated blood from the coronaries into the ventricles bypassing the myocardial capillary network are called thebesian veins. Coronary artery fistulas are rare (<0.2% 1 ), remain silent and often discovered incidentally on coronary angiogram or ventriculography.2 They rarely become haemodynamically significant and become a nonatherosclerotic cause of angina via the coronary steal phenomenon. 3Case reports of steal Figure 1 The flow through the coronary artery fistula (thebesian veins) in the diagonal branch of left anterior descending artery is seen (in late dye acquisition images) as a capillary blush (marked with arrows) in the RAO cranial view. This flow is causing drainage of oxygenated blood directly from coronaries into the ventricular cavity. Figure 2 The flow through the coronary artery fistula (thebesian veins) in the diagonal branch of left anterior descending artery is seen (in late dye acquisition images) as a capillary blush (marked with arrows) in the RAO caudal view. This flow is causing drainage of oxygenated blood directly from coronaries into the ventricular cavity. Figure 3 The flow through the coronary artery fistula (thebesian veins) in the distal right coronary artery is seen (in late dye acquisition images) as a capillary blush (marked with arrows) in the LAO view. This flow is causing drainage of oxygenated blood directly from coronaries into the ventricular cavity.
SUMMARYAnaphylactic reaction to contrast media during selective coronary angiography is a rare occurrence. It can be occasionally resistant to medical treatment leading to cardiovascular collapse and death. The use of intra-aortic balloon pump (IABP) counter-pulsation when the supportive medical treatment fails during anaphylactic shock is not well documented in the literature. We report a case of a severe contrast media-induced anaphylactic shock which failed to respond to the supportive medical management and the timely insertion of IABP for further circulatory support that prevented death in a patient who had an elective diagnostic coronary angiography. The clinical diagnosis of anaphylaxis was challenging at the onset of shock as the typical rash developed after a few minutes. BACKGROUND
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